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Mastoidectomy

Overview

Mastoidectomy is a surgical procedure aimed at removing diseased mastoid air cells, located behind the ear in the mastoid bone. These air cells can become infected due to chronic ear infections, leading to conditions such as mastoiditis, cholesteatoma (abnormal skin growth in the middle ear), or other ear-related disorders. The primary goal is to stop infection, prevent its spread, and in some cases, improve hearing.
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How is Mastoidectomy Done?

  • Medical Evaluation: A thorough ear examination, including audiometry (hearing test) and imaging studies (CT or MRI), will be performed to assess the extent of the infection or abnormal growth.
  • Anesthesia Consultation: General anesthesia is typically used. A consultation will help determine any risks associated with it.
  • Medication Review: Blood thinners, NSAIDs, or supplements that may increase bleeding risk will be reviewed and possibly paused.
  • Fasting: Patients are usually advised to avoid food and drinks for 6–8 hours before the procedure.
  • Consent: The risks, benefits, and potential complications will be explained, and informed consent is obtained.

Mastoidectomy procedures can vary based on the extent of the disease. Common types include:
  • Simple Mastoidectomy: Only the mastoid air cells are removed while preserving the structures of the ear.
  • Radical Mastoidectomy: A more extensive surgery that involves removing the mastoid air cells, part of the ear canal, eardrum, and ossicles (hearing bones). This is done in severe cases where chronic infection has spread.
  • Modified Radical Mastoidectomy: A less extensive version of the radical mastoidectomy where part of the ear canal and ossicles are preserved.
Canal Wall-Up/Down Mastoidectomy:
  • Canal Wall-Up: The ear canal wall is left intact, reducing the need for further surgical care but posing a higher risk of recurrence.
  • Canal Wall-Down: The canal wall is removed, which makes it easier to clean but can affect the ear's natural function.
Procedure:
  • The patient is placed under general anesthesia.
  • An incision is made behind the ear to access the mastoid bone.
  • The surgeon uses a high-speed drill to carefully remove the infected or abnormal air cells.
  • The surgeon will clean out the infected tissue and close the surgical site.
  • In some cases, tympanoplasty (eardrum repair) or ossiculoplasty (repair of hearing bones) may be performed to improve hearing.

Although the procedure is generally safe, possible complications include:
  • Hearing Loss: Partial or complete loss of hearing if the surgery affects the structures responsible for hearing.
  • Facial Nerve Injury: The facial nerve runs through the ear, and there is a small risk of injury, which could lead to facial paralysis.
  • Dizziness or Balance Problems: Temporary or prolonged vertigo may occur postoperatively.
  • Infection: Though the procedure is meant to clear infection, secondary infections or abscesses are possible.
  • Tinnitus: Some patients may develop or experience worsening ringing in the ears.
  • CSF Leak: If the dura (brain covering) is injured, a cerebrospinal fluid leak can occur, leading to more serious complications.
  • Recurrence: There’s a risk that the cholesteatoma or infection can recur.
What are the Benefits of Mastoidectomy ?
  • Prevents Spread of Infection: The procedure can prevent the infection from spreading to nearby structures like the brain.
  • Improved Hearing: In cases of chronic infections or cholesteatoma, the surgery may help improve hearing or prevent further hearing loss.
  • Symptom Relief: Patients typically experience relief from chronic ear pain, drainage, and pressure.
  • Reduces Risk of Complications: Removing the infected tissue reduces the risk of more serious complications like meningitis or brain abscesses.

Infrastructure & Facilities

  • Operating Room: A sterile environment with general anesthesia capabilities.
  • Imaging: CT or MRI equipment for preoperative planning and intraoperative navigation.
  • Microscopic Equipment: The surgery is performed under high magnification to protect the delicate structures of the ear.
  • High-Speed Drill: A specialized drill is used to remove the mastoid bone safely.
  • Postoperative Recovery Area: A recovery ward for observation after anesthesia and to monitor for complications.

FAQs

The procedure typically lasts 2-4 hours, depending on its complexity.

Pain is generally manageable with prescribed pain medications. Patients often experience mild discomfort postoperatively.

Recovery usually takes 2-4 weeks. During this time, patients may have restrictions on activities such as swimming or flying.

Hearing restoration depends on the extent of the damage. Tympanoplasty or ossiculoplasty can be performed during the procedure to improve hearing.

In some cases, additional surgeries may be needed, especially if the cholesteatoma recurs.

Most patients can return to work or school within 1-2 weeks, but this depends on the individual’s recovery and the nature of their job.

Fever, increased redness, swelling, pain, or drainage from the incision site could be signs of infection and should prompt immediate medical consultation.

A mastoidectomy is a complex but beneficial surgery for those with chronic ear infections or cholesteatoma, offering relief from symptoms and preventing serious complications.

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Website Design and Development by Sterco Digitex

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